How Govanhill’s Link Workers Remove Barriers to Accessing Healthcare
“With an intimate knowledge of groups, activities and resources available locally, community link workers play a crucial role in mapping local support systems – keeping individuals and GP practices up to speed with the services available.” Lottie Hanwell on link workers, writing for our language issue.
By Lottie Hanwell | Illustration by Hannah Moshtael
Not all of life’s maladies can be resolved in a 10-minute GP appointment. This is particularly true in the most deprived areas, where the prevalence of patients with complex health needs outstrips the availability of GP appointments.
Glasgow is home to 80 percent of ‘Deep End’ GP practices, a network of Scottish GP surgeries covering the most socio-economically deprived populations. With limited resources and high demand, GPs in the Deep End have limited capacity to get to the bottom of their patient’s problems – especially when those problems are rooted in social circumstances. This is where community link workers like Govanhill’s Leanne Jamieson come in.
Community link workers aim to address the social determinants of health; the non-medical factors that greatly influence health outcomes – from our living and working conditions, to our access to healthy food, education and relationships with others.
Their job adheres to ‘social prescribing’ – a holistic approach to health and wellbeing that connects people to non-medical support in their local communities. This might mean directing someone who’s been feeling lonely to one of Govanhill’s community cafés, or supporting people to keep active by accompanying them to local walking, dance or gardening groups. “It’s about recognising how personal and social circumstances can have a massive influence on mental and physical health,” says Leanne.
With an intimate knowledge of groups, activities and resources available locally, community link workers play a crucial role in mapping local support systems – keeping individuals and GP practices up to speed with the services available.
“The main luxury we have is time,” says Leanne. “GP appointments usually last 10 minutes, whereas we can have up to an hour, sometimes more… This helps us to really get in depth with people, looking at that bigger picture and understanding what’s important to them.”
Considering the vast range of languages spoken in Govanhill – over 50 in Leanne’s practice – interpreters often help to facilitate these conversations. “We’re quite fortunate to have access to in-house interpreters who can attend face-to-face appointments. I think that really breaks down barriers to sometimes quite difficult and emotional conversations.”
Anyone who has learned another language will recognise the difficulty of expressing complex feelings with a limited range of words and phrases. A listening ear, or a conversation in one’s mother tongue, can sometimes be as powerful as any referral, says Leanne: “I might not have been able to find the perfect resource for someone, but often people say: ‘I feel good just having a conversation about it, I feel listened to’.
By acting as a conduit between primary care and the community, link workers are well-placed to identify unmet health needs. “I do think we can play a big role in addressing certain inequalities,” says Leanne. She highlights an example of how local link workers collaborated with community organisations and cervical cancer charity, Jo's Trust to provide cervical screening drop-ins for Romanian and Slovakian speakers in Govanhill.
Read More: Community Link Workers: na straży lepszego dostępu do systemu ochrony zdrowia w Govanhill — Greater Govanhill
But the support provided by community link workers can only extend so far. Social prescribing is an individual solution, not a panacea for the broader, and much more systemic nature of health inequalities facing Govanhill – and Scotland at large. Leanne highlights that housing and financial difficulties account for between 40–50 percent of her caseload.
Link workers can direct people to food banks, or help them to apply for temporary accommodation, but the root of these issues extends far beyond the scope of social prescribing, requiring intervention at a policy and governmental level.
“Community link workers can’t solve systemic health inequalities,” says Roisin Hurst, who runs the Scottish Community Link Worker Network at Voluntary Health Scotland. “But they can certainly support people to get through the periods in their life where medical help is not all that they need.”
Towards the end of 2023, proposed cuts threw the future of Glasgow’s community link worker programme into question. Citing significant financial difficulties, the Glasgow City Health and Social Care Partnership, announced plans to reduce the number of link workers operating in the city by a third. The announcement drew a strong reaction from Glasgow’s medical community; a petition by GPs at the Deep End called on the Scottish Government to sustain funding for this vital community service. The government intervened, announcing plans to commit an additional £3.6 million to safeguard the community link worker programme for a further three years.
Glasgow’s community link worker programme is secure for now, but the longer term outlook for link workers remains uncertain. “I think the reaction to the proposed funding cuts in Glasgow City highlighted just how much people care about community link workers and value what they do,” says Roisin. “We’re certainly overdue a conversation on how to secure a sustainable model for community link workers in the long term.”